2023年版更新的国际腹膜透析学会导管相关感染推荐概览  

Outline of 2023 updated International Society for Peritoneal Dialysis catheter-related infection recommendations

作　　者：阳晓[1] 田娜[2] 路万虹[3] 陈瑾[4] 叶智明[5] 董捷[6] 周启明 李锦滔[7,8] Yang Xiao;Tian Na;Lu Wanhong;Chen Jin;Ye Zhiming;Dong Jie;Kai-ming Chow;Li Philip Kam-tao(Department of Nephrology,the First Affiliated Hospital,Sun Yat-sen University,Key Laboratory of Nephrology,Ministry of Health,Guangzhou 510080,China;Department of Nephrology,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Department of Nephrology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Renal Department and Institute of Nephrology,Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,Chengdu 610072,China;Department of Nephrology,Guangdong Provincial People′s Hospital&Guangdong Academy of Medical Sciences,Guangzhou 510080,China;Renal Division,Peking University First Hospital Institute of Nephrology,Peking University Key Laboratory of Renal Disease,Ministry of Health of China,Beijing 100034,China;Department of Medicine and Therapeutics,Carol and Richard Yu Peritoneal Dialysis Research Centre,Prince of Wales Hospital,the Chinese University of Hong Kong,Shatin,Hong Kong SAR 999077,China)

机构地区：[1]中山大学附属第一医院肾内科卫健委和广东省重点实验室,广州510080 [2]宁夏医科大学总医院肾脏内科,银川750004 [3]西安交通大学第一附属医院肾脏内科,西安710061 [4]四川省医学科学院四川省人民医院肾内科,成都610072 [5]广东省人民医院肾内科广东省医学科学院,广州510080 [6]北京大学第一医院肾内科北京大学肾脏病研究所卫健委重点实验室,北京100034 [7]香港威尔斯亲王医院内科及药物治疗学系,中国香港特别行政区999077 [8]香港中文大学余宇康余雷觉云腹膜透析研究中心,中国香港特别行政区999077

出　　处：《中华肾脏病杂志》2023年第12期964-968,共5页Chinese Journal of Nephrology

摘　　要：腹膜透析(peritoneal dialysis,PD)导管相关感染是PD导管拔除和腹膜炎发生的重要危险因素。2023年国际腹膜透析学会(International Society for Peritoneal Dialysis,ISPD)导管相关感染推荐修订和阐明了出口处和隧道感染的定义和分类,如特定致病菌的导管相关感染、培养阴性导管相关感染、难治性导管相关感染、感染相关导管拔除;推荐出口处感染率新的靶目标不应超过0.40次/患者年;降低了导管出口处局部应用抗生素乳膏或软膏的推荐级别;提出了出口处敷料覆盖的建议;修订了局部应用抗生素及抗生素治疗时间的推荐;推荐了除导管拔除外的挽救导管新方案。该文就指南更新的主要内容进行概述。Peritoneal dialysis(PD)catheter-related infections are important risk factors for catheter loss and peritonitis.2023 International Society for Peritoneal Dialysis(ISPD)catheter-related infection recommendations have revised and clarified definitions and classifications of exit site infection and tunnel infection,such as cause-specific catheter-related infection,culture-negative catheter-related infection,refractory catheter-related infection,and infection-related catheter removal.A new target for the exit site infection rate should not exceed 0.40 episodes per year at risk.The recommendation about topical antibiotic cream or ointment to catheter exit site has been downgraded.New recommendations for exit site infection include clarified suggestion of exit site dressing cover and revised topical antibacterial agents as well as antibiotics treatment duration.In addition to catheter removal and reinsertion,new salvage options for catheter are suggested.The paper outlines the updated main content of the guide.

关 键 词：腹膜透析 导管相关性感染 指南 预防 治疗结局 国际腹膜透析学会指南 

分 类 号：R459.5[医药卫生—治疗学]